Gustavo N Marta1, Rachel Riera2, Paolo Bossi3, Lai-ping Zhong4, Lisa Licitra5, Cristiane R Macedo6, Gilberto de Castro Junior7, André L Carvalho8, William N William9, Luis Paulo Kowalski10. 1. Department of Radiation Oncology, Hospital Sírio-Libanês and Instituto do Câncer do Estado de São Paulo - Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: gnmarta@uol.com.br. 2. Brazilian Cochrane Center and Discipline of Emergency Medicine and Evidence-Based Medicine Universidade Federal de São Paulo - Escola Paulista de Medicina (UNIFESP-PM), São Paulo, Brazil. Electronic address: rachelriera@hotmail.com. 3. Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: paolo.Bossi@istitutotumori.mi.it. 4. Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Electronic address: zhonglp@hotmail.com. 5. Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: lisa.licitra@istitutotumori.mi.it. 6. Brazilian Cochrane Center and Post Graduation Program of Internal Medicine Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. Electronic address: vcrisrufa@uol.com.br. 7. Department of Clinical Oncology, Hospital Sírio-Libanês and Instituto do Câncer do Estado de São Paulo - Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: gilberto.castro@usp.br. 8. Department of Head and Neck Cancer, Hospital do Câncer de Barretos - Fundação Pio XII, São Paulo, Brazil. Electronic address: alopescarvalho@uol.com.br. 9. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, USA. Electronic address: wnwillia@mdanderson.org. 10. Department of Head and Neck Surgery and Otorhinolaryngology, AC. Camargo Cancer Center, São Paulo, Brazil. Electronic address: lp_kowalski@uol.com.br.
Abstract
BACKGROUND: Locoregionally advanced oral cavity cancers are aggressive tumours with high risk of relapse after definitive treatment. This study was performed to assess the effectiveness and safety of induction chemotherapy prior to surgery for untreated oral cavity cancer patients. MATERIAL AND METHODS: Only prospective phase III randomised studies comparing induction chemotherapy followed by surgery with or without postoperative radiotherapy (Chemo Group) compared with surgery with or without postoperative radiotherapy (Control Group) were eligible. Two of the authors independently selected and assessed the studies regarding eligibility criteria and risk of bias. RESULTS: Two studies were selected. A total of 451 patients were randomly assigned to Chemo Group (n=226) versus Control Group (n=225). Most patients had tumours at clinical stages III/IV (89.1%). Both trials were classified as having low risk of bias. No significant overall benefit in favour of induction chemotherapy was found regarding loco-regional recurrence, disease-free survival and overall survival. A subgroup analysis of individual data from cN2 patients showed statistically significant overall survival benefit in favour of induction chemotherapy. The included studies did not directly compare toxicity between the groups and no statistical analysis was performed regarding safety outcomes. CONCLUSIONS: Based on the available studies, induction chemotherapy when administered before surgery with curative intent did not improve clinical outcomes in locoregionally advanced oral cavity cancer patients. Clinically assessed N2 patients might benefit from induction chemotherapy.
BACKGROUND: Locoregionally advanced oral cavity cancers are aggressive tumours with high risk of relapse after definitive treatment. This study was performed to assess the effectiveness and safety of induction chemotherapy prior to surgery for untreated oral cavity cancerpatients. MATERIAL AND METHODS: Only prospective phase III randomised studies comparing induction chemotherapy followed by surgery with or without postoperative radiotherapy (Chemo Group) compared with surgery with or without postoperative radiotherapy (Control Group) were eligible. Two of the authors independently selected and assessed the studies regarding eligibility criteria and risk of bias. RESULTS: Two studies were selected. A total of 451 patients were randomly assigned to Chemo Group (n=226) versus Control Group (n=225). Most patients had tumours at clinical stages III/IV (89.1%). Both trials were classified as having low risk of bias. No significant overall benefit in favour of induction chemotherapy was found regarding loco-regional recurrence, disease-free survival and overall survival. A subgroup analysis of individual data from cN2patients showed statistically significant overall survival benefit in favour of induction chemotherapy. The included studies did not directly compare toxicity between the groups and no statistical analysis was performed regarding safety outcomes. CONCLUSIONS: Based on the available studies, induction chemotherapy when administered before surgery with curative intent did not improve clinical outcomes in locoregionally advanced oral cavity cancerpatients. Clinically assessed N2 patients might benefit from induction chemotherapy.
Authors: Thaís Bianca Brandão; Karina Morais-Faria; Ana Carolina Prado Ribeiro; César Rivera; João Victor Salvajoli; Marcio Ajudarte Lopes; Joel B Epstein; Praveen R Arany; Gilberto de Castro; Cesar Augusto Migliorati; Alan Roger Santos-Silva Journal: Support Care Cancer Date: 2018-02-08 Impact factor: 3.603
Authors: Ambika Parmar; Michaelina Macluskey; Niall Mc Goldrick; David I Conway; Anne-Marie Glenny; Janet E Clarkson; Helen V Worthington; Kelvin Kw Chan Journal: Cochrane Database Syst Rev Date: 2021-12-20
Authors: Diego Vicente; Miguel Patino; Rebecca Marcus; Heather Lillmoe; Preparim Limani; Timothy Newhook; Andy Lee; Ching-Wei Tzeng; Yun Segraves-Chun; David Tweardy; Vijaya Gottumukkala; Jean-Nicolas Vauthey; Thomas Aloia; Juan P Cata Journal: Oncotarget Date: 2019-01-15
Authors: Ramez Philips; Chihun Han; Brian Swendseid; Joseph Curry; Athanassios Argiris; Adam Luginbuhl; Jennifer Johnson Journal: Front Oncol Date: 2021-07-01 Impact factor: 6.244